Monday, March 13, 2017

The Power of Infertility

Infertility can change you.

Really, that's an understatement. It does change you... at your core. It has the capacity to inevitably rewrite so much about your life. About who you are. About how you see things. It has a strength that can become all consuming.

All of this starts out as the excitement for wanting to start (or grow) your family, but then slowly morphs into a desire... and then into a longing. A longing to be pregnant. A longing to have a baby. And before you know it, that longing can begin to take a painful turn.

It can become a nagging pain... and then an intense pain, that you seem to be reminded of often. Reminded of at many innocent moments when you're least expecting it. Those moments when you're driving down the street and a pregnant woman walking down the sidewalk catches your eye. The moment when your searching for a parking spot and excitedly begin to pull into an open one near the front, only to realize it's reserved for "Expectant Mothers." The moment when your colleagues begin talking about all their weekend plans with their children, and you are starkly reminded that you don't have any children... Or that awkward moment when someone asks you, "Oh, do you have kids?" and when you politely say no, they proceed to ask, "Do you want any?"...if they only knew...

If they only knew how badly I want a child. How much I'm struggling to try and have a child. How much I have gone through, and continue to go through, to have a child...

If they only knew that I think about not having a child, and about the child we had to loose, more times a day than can probably be counted...

If they only knew... then they might begin to have a glimpse into exactly the power that infertility can have, and how it can rob you of oh so much. It has a strength to begin to change the way you view the world around you, and yourself for that matter.


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All that we have gone through in our battle with infertility has definitely reshaped me at my core. It's changed the way I think, the way I feel, the things I see and notice, the things I do everyday... It's changed who I am.

But the beauty in all of this...

I still have a choice.

I can choose to let it break me, and tear me down... Or I can choose to keeping moving forward and embrace it.

Embrace it?

Yes, I have chosen to embrace (and accept) my infertility. Trust me though, it hasn't always been easy, and it's undoubtedly been a long and arduous road to get here (and truthfully, I'm probably not even here on some days).

But as I look back to the early days of this journey, I'm reminded of where I started -- of the woman I was almost 3 years ago, who was in complete denial of the dreaded word: INFERTILITY. I not only didn't want to accept it, I whole-heatedly refused to accept it. It wasn't me and I didn't want any part of it.

But that's the thing about life - no matter how hard or how much we try to ignore reality, it's still there... and it will continue to be there until the moment we're ready to turn around and face it.

So that's what I did and that's what I choose to continue to do. I've accepted that this is our reality, and now I'm learning to embrace this path we've been set on. There's no sense in denying it or fighting it, or trying to refuse the reality of it... it just is.

At every moment, I have the choice to embrace or the choice to deny... I chose to embrace. And as I embrace, I continue to fight and look forward. Fight for the family I know we will have one day. Fight for the memory of the little peanut we had to say good-bye to. Fight through all that it continues to take to one day grow our family... and look forward to the moment when that comes to fruition.

As I continue to fight and look forward, I just have to focus on those things around me that I can draw strength from. My amazing husband who has been and continues to be my rock... and really, the one person who can understand exactly what this journey is. Our supportive family and friends, who continue to fight with us.., cheer during our celebrations and cry with us during our heartaches.  And most importantly, the foundation upon which I'm able to stand while going through all of this: my faith... and trust in Jesus.

In fact, my faith even reminds me of the promise that good can actually come, even out of the most difficult of circumstances, because God always does have a purpose... and although I may not be able to clearly see exactly what that purpose is right at this moment, I still know it to be true.

Even "in oceans deep, my faith will stand"... And that, is the one thing that I continue to hold on to through all of this...

Monday, February 13, 2017

Becoming One with the Needle... Again


The process to prepare for the upcoming Frozen Embryo Transfer (FET) has slowly begun. At this point, we're looking at about two months out (give or take), so I recently started birth control pills again (I swear, the irony of that one will be something I never get over!)... and also ordered the different medications I'll need, and those arrives the other day.

Among them is, drum roll please... (and cue music signifying "impending doom"):

The dreaded Progesterone in Oil - also known as PIO shots.

Ahhhhh...

As I look ahead to having to give these injections, all I can think about and all that keeps swimming through my head is the horror stories I've heard...

In all that I've been through up until this point, for some reason, I swear the thought of these shots scares the heck out of me! I'm literally terrified...

What's so bad about them you might ask, well, let's start with the fact that they are intramuscular injections... In laymen's terms, this means a really big needle that must go through the muscle when you inject it. Yikes! Up until now, most of the shots (at least the self-administered ones) have been subcutaneous, meaning a small needle that basically just injects the medicine right below the surface of the skin into the fat, and then your body absorbs it from there. 

I've had a few intramuscular shots before when I've taken my HcG trigger shots, but the intramuscular ones were done in Dr. M's office by one of the nurses, so we've never had to give them ourselves (I say "we" because my husband is amazing and helps me with pretty much all of the shots).

The second frightened aspect is the fact that I will literally be injecting oil into myself. I don't know why, but for some reason this just seems weirdly unnatural... then again, what part of any of this process has been "natural"?

In addition, I've heard numerous stories that the shots are painful, the oil hurts when going in, the oil can be tough going in, there can be irritation or swelling/ lumps that form at the injection site, all kinds of fun stuff, ugh.

Of course, I've never been one to be afraid of needles or put off by a little pain or discomfort, and again, at this point, I'm pretty used to all that... but for some reason, these darn PIO shots are really psyching me out.

I have my consultation appointment set up for first thing tomorrow morning, where I'll go through some different consent forms and information to prepare for the upcoming transfer, and then will have a training session on exactly how to administer these shots - - so we'll see how that goes. I'm sure I'm just getting myself worked up into a tizzy about this for nothing, but for some reason these darn little shots are already taking me for a ride and I haven't even started them yet... What fun.

Ladies who have been down this road before, any thoughts? Advice? Experiences? I know I've seen, heard, and read little tips and tricks here and there before, so any advice is more than welcomed... until then, I will just sit here and continue to stew over the fear of these radical little shots :) 

Saturday, February 4, 2017

Drama on ER Day... and My Popsicles


After my egg retrieval (ER) surgery a couple weeks back, I'm all recovered up at this point... and for the most part, everything went well. The surgery itself was quick and went as expected. The hubs and I arrived to Dr. M's office bright and early for our 6:30am appointment. We checked in, and not long after, we were called back to our room to be prepped and wait for the procedure.

After signing some more consents, getting an IV started, and reviewing what to expect with the nurse, we had a slight hiccup of drama right before I was scheduled to head back into the room for the ER.

Because of my over-response to the hormone injections this cycle, and the elevated risk that put me at for Ovarian Hyper-Stimulation Syndrome (OHSS), one of the nurses had told me a few days prior that they were calling in a prescription order of Ganirelix for me, to my mail-order pharmacy. I've used this pharmacy a number of times in the past, and typically every time Dr. M's office calls in an order, the pharmacy then calls me within a day or two to confirm and finalize the order for delivery. So when the nurse mentioned this, I didn't think anything of it, and just figured the pharmacy would call me as they always have.

Long story short, on the day of the ER, as the nurse was reviewing everything with me prior to the surgery, she mentioned that I would be starting the Ganirelix later that day, and would continue on the daily injection for a total of 7 days... "Uhhhh, I don't have the Ganirelix" I said to her.

And she looked at me with what I would describe as a slight look of terror...

"What do you mean you don't have it yet?  We called in the prescription for you?  It's important that you absolutely start on this medication today!" she said.

"Well, the pharmacy never called me and when I spoke to the nurse the other day, she just mentioned it in passing, and never specifically told me when I was supposed to start so I didn't know I needed it today. I was just waiting for the pharmacy to call me about it like they always do."  Miraculously, I was still somehow staying clam at this point.

The nurse said she would go and check to see if they happened to have one dose of it on hand in the office that they could give me for that day, but mentioned that she was doubtful they would... and mean while, I proceeded to get on the phone with the pharmacy to raise hell.

For the entire 15min. prior to being whisked into the procedure room, I spoke with numerous pharmaceutical representatives, and managers, and pharmacists, and customer service reps., literally having to explain my situation over and over again (while continuing to throw in the line that, "I'm sitting here about to go into surgery in a few minutes, and I need this medication today in order to prevent some post-op. complications that I'm at risk for ")... as if that would somehow magically help the medicine fly across the country from their warehouse to my front door.

Basically, it took 5 different people to finally get a straight answer: "The earliest possible time we could get this medication to you would be tomorrow morning, with overnight priority shipping."

"Wellllll, that's not going to work..."

Awesome.

Looks like we'll have to figure out a Plan B and cross our fingers that another local pharmacy has it in stock AND that insurance will cover it, or else we're choking down the $189 for one dose.

At that point... it was time for the ER.

And the Ganirelix drama was not the stress I needed at that moment.

Literally, always something...

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Regardless, the retrieval did go good... and the next thing I knew, I was back in the room reunited with my husband, apparently saying the same things over and over again and not remembering, because of the anesthesia :)

Immediately after the ER they told us how many eggs they were able to retrieve, and the next day we learned how many fertilized... and then a few days later we learned how many made it to the blastocyst stage.

All of it was, and still is, a very surreal experience.

(Ok, ok, at this point I know you're dying to know the meat of this all and what the ER stats were, so I won't make you wait any longer...)

I went in with approximately 30 follicles, and we were able to retrieve 25 eggs... Whoa.

Of those 25, 18 eggs were mature.

One a side note: Once the hubs and I had learned a few days prior that I was over-stimming, we, along with some guidance from our team at Dr. M's office, had decided that we may potentially not attempt to fertilize all of the eggs retrieved (just depended on the number we got), because we wanted to be conservative and limit the number of embryos we had (I know, not your typical IVF approach... and again, a post for another day). So we had gone into the ER with a maximum number of eggs in mind that we would attempt to fertilize.

Now back to our stats...

So we had 18 mature eggs, and of those 18 we had decided to try and fertilize 12 of them, using ICSI (our clinic uses it for all cases... It's basically where they inject the sperm directly into the egg, rather than just placing the egg and sperm together and letting fertilization attempt to occur on it's own).

Therefore, because of our choice, we were also able to freeze 6 of my eggs (obviously, unfertilized)... So this is nice to have as a back up plan down the road, if needed.

Of the 12 that we attempted to fertilize, 10 actually did fertilize.

And of those 10... 6 made it to the blast. stage and were able to be frozen. So at this point, we have 6 little popsicles in the freezer... and we're hoping to be able to transfer sometime in the next couple of months.

Until then, my heart belongs to my 6 popsicle babes... until the day that I can give each one an opportunity to come home...

Thursday, January 19, 2017

Is Today Like Easter?



Here we are, the day of my egg retrieval (ER)surgery, and as I sit here at 5:30am, preparing to leave the house soon, I can't help but have the random the thought, "Is today like Easter?"

I mean, Dr. M is going to go around inside my ovaries looking for and scooping up as many eggs as possible?  That's pretty much what little kids do on Easter, right? Go around and collect eggs (not the "inside my ovaries" part)?

Ha.

Come on, I need to still be able to find some humor in all of this... so this is my attempt.

At least I made myself laugh (well, more like chuckle) this morning. And being in good spirits before going into the ER has to be worth something, right? I think so.

At this point, I'm ready to have these eggs out of me... all 30+ of them (yup, that many... remember, I hyper-stimmed, blah). So, I'm pretty bloated, uncomfortable, and it hurts to just sit down sometimes, and also trying to be very careful not to inadvertently do something to accidentally twist an ovary (called ovarian torsion).

So, we're about to be off... and get this Easter party started...

Wednesday, January 18, 2017

Red Light, Green Light... Red Light


Sooooo, it's been awhile (again) since my last update and continuing to go with the trend of my infertile life, it's been a ride...

After getting through and working to move past the devastation of the ectopic pregnancy that we faced (which began back in August), we had a consultation with Dr. M. to discuss recommended next steps.  In a nutshell, Dr. M. said that the first step would be to re-run a hystero-sonogram to check if my tubes were still open.  From there, we could again repeat an IUI using injectibles because, in his words, "After all, it did work this last time and we did achieve pregnancy... it was just in the wrong spot"... Or, we could consider moving to IVF.

Long story short - we decided to do IVF (perhaps another post in the future with more details on us actually making that decision, because it wasn't easy).

But I digress.

So we began moving forward towards IVF in early December.  Because of some of my labs, levels, and diagnostic testing, Dr. M. decided to put me on the long Lupron down-regulation protocol (or something along those lines that it's called). Anyways, bottom line is that Dr. M. put me on both Birth Control (BC) pills and Lupron injections for a few weeks prior to the anticipated start of my cycle/ the start of the hormone injections... The irony, right?  BC pills for someone who is not only trying to get pregnant, but having trouble getting pregnant?! Yes, sometimes that's just how it works.

Anyways, my new cycle was expected to start a few days after stopping the BC pills, so we waited for that to happen so that we could start the hormone stimulation injections. And we waited...

And waited some more...

And then waited even more for my cycle to start... and it never did. Ugh.

So a couple of days before the cut-off of when I would be able to start an IVF cycle (Dr. M's office doesn't do IVF every single day, so there are certain times throughout the month when you're able to start a cycle... Annoying, right?! Yes, I agreed!), they decided to just bring me in for baseline blood and ultra sound... just to check and see if maybe I was ready. They explained that sometimes the Lupron injections can really thin your uterine lining and cause you to not have a full cycle, or sometimes even just spot.

So I went in for the baseline blood and ultra sound on a Thursday, and when they called me later that day with the results of my tests, they said my body was definitely not ready to start the stim. injections.  All my levels were still extremely high and my body was no where near starting my period.

Man, so frustrating... Why can't my body just cooperate? Just once? Is that too much to ask?

At that point, the nurse said that Saturday was the last possible day to start, so they wanted me to come back in on Saturday morning to re-run the baseline tests, in case by chance, my body happened to be ready at that point. So I scheduled that.

The next day, on Friday, I had to chat with one of the IVF nurse coordinators regarding a few questions I had, and during that conversation she proceeded to tell me that she had reviewed my case with another nurse and they had determined that there was no way that my levels would drop that significantly from Thurs. to Sat, so I should just cancel my appointment (as to not have unnecessary tests done), and just wait until my period fully started to reset everything, and then we could restart the IVF cycle during the next round the following month - - RED LIGHT.

So I canceled my appointment... another blow. SOOO disappointing.

The next morning on Saturday, lo-and-behold, what do I wake up to??  Good ole' aunt flo'.

A big UGH... why couldn't you have arrived just a day or two sooner auntie??  Darn you for being so late.

So as instructed, I called Dr. M's office and left a message just to let them know I had "officially" started my cycle... and then I headed out to meet two of my good friends (who I hadn't seen in a few months) for a much needed, long-overdue breakfast date.

In the midst of breakfast with my girls, just as our food was being delivered to the table, I randomly looked at my phone and noticed I had a voicemail from Dr. M's office... So I listened to it.

The message was from one of the nurses who semi-frantically was instructing me to "get into the office right away this morning, before 9:45, to have some blood drawn" since my period had started.

What?!  Seriously? Come on... didn't we just go over this? My levels were all so high on Thursday so even though my period started, there's no way they would drop so quickly to be able to start. Besides, you typically aren't started on stims. until a couple days into your cycle, so what are the chances that I would be ready so soon?

Begrudgingly, I cut my much-anticipated breakfast date with my girlfriends short to crazily rush over to Dr. M's office... had my blood drawn... went home... waited for the voicemail with results... got the results... and heard the nurse say, "All your levels are great!  They all miraculously dropped and you are good to go and start your injections tonight"... WHAT?!?

Seriously?! Talk about a miraculous turn of events! And something positive for once! Praise God! - - GREEN LIGHT.

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Fast forward a couple weeks worth of injections later, and that brings us to yesterday. I went in yesterday morning for what we anticipated would be my last blood and ultra sound monitoring before the egg retrieval, and then I waited for the results. I got the voicemail towards the end of my afternoon as I was getting ready to leave my office for the day.  The first thing that I hear the nurse report out on was my Estradiol/ Estrogen (E2) level. It was almost 5,700... then I hear her explain, "Please just note that with an E2 level that high, any embryos will be frozen because it's not an optimal environment for implantation and pregnancy..." WHAT?? Again, is this really happening??

In a nutshell, my body over-stimmed (yet again, similar to one of my IUI cycles). My estrogen shot through the roof, and I now have 17 follicles on the right side and 13 on the left. AHHHHH!!!... So they canceled the transfer and we need to now wait to do a future frozen embryo transfer (FET) cycle, until my levels can return within normal range - - RED LIGHT... AGAIN...

I'm still scheduled for my retrieval surgery bright and early tomorrow morning, so we're hoping that all goes well. And also hoping, and praying, that my body can stabilize itself afterward, since I'm now at an elevated risk for OHSS (oviarian hyper-stimulation syndrome), a nasty complication that can occur after retrieval.

And that's that folks. A big, long update to try and recap the last couple months of life... and our big step forward into the terrain of IVF...


Friday, November 25, 2016

Tough Decisions

After all of the gut-wrenching difficulty, pain, and sadness from finding out we were pregnant... to then finding out it was ectopic (you can catch up on that story if you missed it, in The Roller Coaster and the Roller Coaster - Part 2), the difficulty continued on.

After Dr. M confirmed that the pregnancy was in fact in my left tube and that it wasn't viable, we were given our two options for terminating: Laparoscopic surgery to manually go in and remove it or injectible medication called Methotrexate that would help end the pregnancy.  After discussing both options with Dr. M, as well as the potential negative effects of both, he explained that, "If you were my daughter, I would honestly recommend the Methotrexate... but of course, it is completely up to you guys and either option would be ok."

Dr. M and the ultra sound tech. then left the room we were in to give the hubs and I a few minutes to gather ourselves and think about it, and told us we could come into the consultation room to meet with the nurse when we were ready, to discuss next steps.

So they left the room... and my husband and I looked at each other, lost... and we both just cried. How could all of this be happening? It just didn't make any sense? It wasn't fair... but then again, we were so far past the point of "fair" in all of this...

We had no choice, but to do the best we could to gather ourselves, and begin to discuss which option to choose so that we could move forward... And at that point, my naturally analytical mind began to race through each option, from all angles.

The Option of Surgery: Of course this was the more invasive of the two, but then again, probably the "quickest" and most efficient in ending the pregnancy. However, the risk (other than it actually being a "surgery" under general anesthesia), as explained by Dr. M was that there was a small possibility that not all of the cells from the pregnancy actually get removed and can sometimes continue to grow, which would mean taking a dosage of the injectible medication anyways.

The Option of Medication: The downside of this option was that the medication used is a very strong medication, often used in chemotherapy, because it's designed to attack living, rapidly-growing cells within the body (such as a developing pregnancy) and kill them. There were also various side-effects associated, such as severe cramping, nausea/ vomiting, headache, sores in the mouth, and even hair loss (which isn't very common when used for this purpose, but still possible). In addition, Dr. M explained that in a very small number of people, the initial dosage doesn't always work and sometimes a second dosage may be needed, which is even more taxing on the body. Even more so, the thought of pumping myself full of intense, poisonous drugs, all while I'm here trying to eat organically and remove almost all toxins from my body and my environment, seemed ridiculously unfair... and not to mention the irony.

However, based on Dr. M's recommendation, and taking into account that the first option was still surgery, and that I did have some difficulties after my first surgery, we decided to go with the Methotrexate.

From there, we discussed everything with the nurse coordinator, signed papers, and scheduled a time for me to come in the next day to actually be administered the medication (since it took about a day for them to get insurance approval and order the correct dosage for me, based on height and weight).

So the next afternoon, in the middle of my work day, I had to make a "pit-stop" at Dr. M's office to have the medication administered.

While I call it a "pit-stop," it was actually nothing shy of the worst appointment of my life. As I pulled into the parking lot a few minutes early, I just sat there in my car, processing the gravity of what I was about to do. What I had been forced to do.

I sat there and cried. I talked to my little bun (whom we had named "Baby E"). I apologized for having to do what I was about to do. I told him or her how much me and daddy loved them. I thanked him or her for the sacrifice they were making: to only live for a short, short while in my belly, but at the same time to bring hope to mommy and daddy that it was possible to get pregnant. I explained how I knew one day we will be able to be with him or her when daddy and I are called back home to heaven. I shared how much love already existed for this tiny little peanut, from so many people, and how he or she will always be in our hearts. I asked little Baby E to always watch over mommy and daddy... and to also take care of his or her's future siblings in heaven until mommy and daddy get the chance to meet them one day.

...And I cried.

...And cried some more...

And then I gathered myself, as much as possible, took a deep breath,,, and walked into Dr. M's office to do the most difficult thing that I've ever had to do...


Sunday, October 30, 2016

The Roller Coaster - Part 2



Continuing on from my previous post, The Roller Coaster, even though my HCG levels weren't rising as expected, Dr. M still seemed hopeful and simply wanted to wait a few more days and check again... so that's what we did.

At the next follow up blood test, my levels continued to rise slowly, but again not doubling... and this time, they rose even more slowly than the first time.  At this point, I knew something might be wrong, but I still held out hope and continued to pray and just stay positive.

Of course, cue in the unleashing of my frantic obsession with Googling during every free moment I had, in order to continue to find those hope stories where women had slow rising HCG, but continued to go on and have healthy, full pregnancies... and although finding those cases where few and far between, I found them and held out hope.

Typically, when HCG levels are not rising at the appropriate rate (i.e., doubling at least every 2-3 days max), that's often a sign of an impending miscarriage, due to any variety of things. And even though that was the outcome in about 95% of the stories, blogs, and message boards that I found, I.Still.Had.Hope...

At this point, Dr. M had said let's wait a week and come back in for additional follow up blood work and to try and do a preliminary ultra sound to see if we could actually see anything.

So that's what we did.

A week later, I went in for more blood work and an ultra sound. I was literally beside myself with anxiety, fear, anticipation... you name it. I wanted so desperately to have them be able to see some, even a small, remnant of gestational sac. Something to know that it was really there... that there was some "proof" of our baby that had been conceived...

But there was nothing.

The ultra sound tech. assured me that it was still too early and the likelihood of actually seeing "something" was pretty much non-existent, given that my HCG levels were still barely skirting around 1,000 and that I was merely around only 5 weeks. So again, I still had hope.

Dr. M had me wait another week, and then come back for more blood and another ultra sound. So that's what we did. Like deja vu all over again, I went back it and laid on the ultra sound table in silent hope that we would be able to see something...

And just like last time, even though my HCG levels continued to rise slowly, the tech. said, "I'm sorry, but I'm still just not seeing anything..."  My heart sank, but I quickly tried to remind myself that it could still be early and that as long as my levels were continuing to rise, I clearly wasn't having a miscarriage at that point.

Then suddenly, I heard the tech. say, "Oh wait, I do see something - here it is... Unfortunately, it's outside the uterus... I'm sorry"

My heart sank even deeper...

She proceeded to explain to me that it looked like the baby had implanted in my left Fallopian Tube...

My darn tubes... They have been the problem since the beginning... Ahh...

But this wasn't supposed to happen.  We knew that my left tube had the bigger issue... and even though I had surgery to correct the issue and completely open them back up, Dr. M still played it conservatively and "pushed right" as he called it. Meaning, he focused mostly on my right side and waited for the most mature follicles to develop on the right side. And this cycle, I didn't even have any larger sized follicles on the left side, they were all on the right... so how did this happen? How did a little, seemingly small and immature follicle from the left side produce an egg that got fertilization and managed to implant?!?

What a nightmare.

The next day Dr. M wanted to repeat the ultra sound again, with him present, just to be absolutely sure that we were seeing it correctly and that it was in fact in my tube, with no possibility of it being a viable pregnancy... so that's what we did... and I appreciated this additional check for certainty on his part.

Over the course of the next 24 hrs. we cried, we prayed, we shared the situation with our immediate family and had them pray too... all of us just asking, hoping for a miracle. That some how we misread the first ultra sound and it was in fact in my uterus. That some how a miracle would happen and the pregnancy in some way, shape, or form could be saved. Something. Anything. We prayed, all while still wanting to be in alignment with God's will and plan, no matter what it was... Talk about hard.

The next day, we had the ultra sound with Dr. M present... and he confirmed it, it was in my left tube, therefore it was ectopic. There was nothing any of us we could do, as it wasn't viable...

And we were left only with the choice to terminate, and force a miscarriage...



...And as if that wasn't the hardest part to swallow already, unfortunately the nightmare wouldn't and couldn't just end for us there...